not require further analgesia. Nausea or vomiting was a presenting feature of pancreatitis in 11 patients treated with pethidine and 15 with buprenorphine. This settled after analgesia in six and seven patients respectively. Only one patient receiving buprenorphine developed vomiting after administration of the drug. Specific questioning did not elicit any other side effects. Comnparisont of median pain scores before and after injection of pethidine and buprenorphine Pethidine Buprenorphine (n = 15) (n = 17) Linear analogue scale (range 0-10): Before injection 9 1 8.4 After injection 3 6 2-5 Difference 5 9 5 4 Ordered category scale (range 0-3): Before injection

Sarcoidosis is quite common in American and West Indian blacks. In America, the incidence in blacks could be up to 10 times higher than in whites. Sarcoidosis is generally believed to be rarer in African blacks and especially along the West African coast from which the American blacks trace their ancestry. The difference in incidence may be due to environmental influences, poor reporting system from inadequate local awareness of the presentation, confusion with tuberculosis, and lack of the Kveim antigen. Diagnosis of sarcoidosis is most commonly made from the pulmonary and skin manifestations. Since the skin manifestation presents readily for observation without the need for costly devices like x-ray machines, the present study focused on and analyzed the seven cases seen in the skin clinic within a period of 2 years (an incidence of 0.85%), showing that the commonest presentation was as scar-sarcoid on longstanding tribal marks. Tribal scarification is common in West Africa, and one should investigate any change in a longstanding scar. This heightened awareness in areas where scarification is or was practiced could end the belief of the rarity of sarcoidosis in the West African subregion.

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During a 2 year-period 12 Nigerians with sarcoidosis were diagnosed at the chest and dermatology clinics of the University College Hospital, Ibadan, Nigeria. Intrathoracic involvement was the commonest presentation followed by the skin, lymph nodes and liver. Histological diagnosis was obtained in all cases either from skin biopsy, transbronchial lung biopsy, lymph node or liver biopsy where applicable. This study suggests that sarcoidosis is not as rare as previous literature on the subject portrays.

Epidural analgesia is widely used as an effective method of pain relief in labor. This study was therefore designed to investigate the awareness and level of utilization of obstetric analgesia in labour among pregnant women in Wesley Guild Hospital Ilesha, Nigeria. The descriptive study involving 110 pregnant women revealed that about half (41.8%) of the respondents had poor knowledge score, 37.3% had fair knowledge, while 20.9% had good knowledge score on obstetric epidural analgesia. Only 10.9% of the respondents had used epidural analgesia and 83.3% were satisfied with the use. There was a significant relationship between knowledge of respondents and the use of obstetric epidural analgesia. Moderate awareness, poor knowledge and low level of utilization of obstetric epidural analgesia were documented. There is a need for adequate awareness programs to enhance the knowledge of epidural analgesia and its utilization among pregnant women in order to reduce the excruciating labour pain.